Preoperative detection and management of tracheomalacia in advanced laryngotracheal stenosis.
OBJECTIVE
To determine the predictive value of endoscopic examination and radiological imaging in the evaluation of substomal tracheomalacia in advanced laryngotracheal stenosis.


METHODS
Forty nine patients with advanced laryngotracheal stenosis were preoperatively evaluated with radiological (magnetic resonance imaging [MRI]) and endoscopy to determine the grade of laryngotracheal stenosis and presence of substomal tracheomalacia. The intraoperative findings were compared with the preoperative findings, and the percentage of operative plan changes was calculated.


RESULTS
In a preoperative evaluation, 37 patients were found to have no substomal tracheomalacia; but during the surgical procedure, we detected substomal tracheomalacia in 12 (32.4%) of these patients and changed our preoperative plan during the procedure (p < 0.05).


CONCLUSIONS
Laryngotracheal reconstruction plans are dependent on preoperative evaluations which can change significantly during the surgical procedure. Therefore, experienced physicians who can alter the preoperative plan immediately during the procedure and successfully perform an alternative procedure are necessary.
Cansiz
H
H
Istanbul University, Cerrahpaşa School of Medicine, ENT Department, Istanbul, Turkey.
Yener
M
M
Tahamiler
R
R
Pamukcu
M
M
Acar
G O
GO
Sekercioglu
N
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D006801:Humans; D007829:Laryngostenosis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014135:Tracheal Stenosis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D055090:Tracheomalacia / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D055815:Young Adult